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Original Article
- Organic solvent exposure for the chronic kidney disease: updated systematic review with meta-analysis
- Chaeseong Lim, Hyeoncheol Oh
- Ann Occup Environ Med 2023;35:e11. Published online May 17, 2023
- DOI: https://doi.org/10.35371/aoem.2023.35.e11
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Abstract
Abstract in Korean
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ePub Background Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies.
Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text.
Results Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72–3.47). The risk of a low-level exposure group was 1.07 (0.77–1.49). The total risk of a high-level exposure group was 2.44 (1.19–5.00). The risk of glomerulonephritis was 2.69 (1.18–6.11). The risk was 1.46 (1.29–1.64) for worsening of renal function. The pooled risk was 2.41 (1.57–3.70) in case-control studies and 2.51 (1.34–4.70) in cohort studies. The risk of subgroup classified as ‘good’ by the Newcastle Ottawa scale score was 1.93 (1.43–2.61).
Conclusions This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.
Trial Registration PROSPERO Identifier:
CRD42022306521 - 유기용제와 만성 콩팥병 ; 갱신된 메타-분석
목적
유기용제는 많은 산업현장에서 널리 사용되고 있는 물질로, 산업현장 근로자들의 건강에 나쁜 영향을 초래하고 있다. U.Ravnskov et al, 2000 에서는 유기용제 노출과 만성 신부전에 대해 조사했던 환자-대조군 연구들을 모아 메타분석을 시행하였다. 해당 메타 분석이 발표된 이후 만성 신부전의 정의가 변경되었으며 새로운 코호트 연구들도 새로 발표되었다. 따라서 본 연구에서는 기존 메타 분석에서 포함되지 못한 연구들을 추가로 포함하여 업데이트된 메타 분석을 시행하였다.
방법
본 체계적 검토는 Preferred Reporting Items For Systematic Reviews and Meta-Analysis(PRISMA) guideline 에 의거하여 진행되었다. 검색은 Embase 와 MEDLINE 데이터베이스를 활용하여 2021년 11월 9일날 시행되었다. 유기용제 노출에 의한 만성 신부전에 대한 총 위험도와 더불어, 저도 노출, 중등도 노출, 고도 노출로 구분된 논문들을 모아 노출강도에 따른 하위그룹의 위험도 또한 분석하였다.
결과
유기용제 노출군은 비노출군에 비해 만성 신부전에 대한 총 위험도 (pooled risk) 는 2.44(1.72-3.47) 로 나왔다. 저도 노출의 경우 위험도 1.07(0.77-1.49) 로 나타났고 고도 노출군의 경우 총 위험도 2.44(1.19-5.00) 로 나타났다. 사구체 신염 발생의 경우 위험도가 2.69(1.18-6.11), 신기능 악화의 경우 1.46(1.29-1.64) 로 나타났다. 환자-대조군 연구들의 경우 2.41(1.57-3.70), 코호트 연구들의 경우 2.51(1.34-4.70) 으로 나타났다. Newcastle Ottawa scale 점수가 ‘좋음’으로 분류된 연구들의 경우 1.93(1.43-2.61)로 나타났다.
결론
선행 연구와 마찬가지로 혼합 유기용제 노출 근로자에서 만성 신부전의 위험성이 유의하게 증가한 것을 확인하였다. 이는 현재 석유 관련 제품 취급자, 도장공, 금속가공, 실험실 근로자 등 혼합 유기용제 고용량 노출군에 대한 특수건강진단 시 신기능 검사나 단백뇨 검사의 범위를 넓혀야 함을 시사할 수 있다.
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Research Article
- The association between shift work and chronic kidney disease in manual labor workers using data from the Korea National Health and Nutrition Examination Survey (KNHANES 2011–2014)
- Jun Young Uhm, Hyoung-Ryoul Kim, Gu Hyeok Kang, Young Gon Choi, Tae Hwi Park, Soo Young Kim, Seong Sil Chang, Won Oh Choo
- Ann Occup Environ Med 2018;30:69. Published online December 14, 2018
- DOI: https://doi.org/10.1186/s40557-018-0279-z
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Abstract
PDFPubReaderePub
Objective Kidneys are organs having a biological clock, and it is well known that the disruption of the circadian rhythm increases the risk of chronic kidney disease (CKD), including the decline of renal and proteinuria. Because shift work causes circadian disruption, it can directly or indirectly affect the incidence of chronic kidney disease. Therefore, the purpose of this study was to investigate the association between shift work and chronic kidney disease using a Korean representative survey dataset.
Methods This study was comprised of 3504 manual labor workers over 20 years of age from data from the fifth and sixth Korea National Health and Nutrition Examination Survey (2011–2014). The work schedules were classified into two types: day work and shift work. The estimated glomerular filtration rate, which is the ideal marker of renal function, was estimated according to the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and chronic kidney disease was defined as urinary albumin to a creatinine ratio equal to or high than 30 mg/g and/or estimated glomerular filtration rate lower than 60 mL/min/1.73 m2. The cross-tabulation analysis and multivariate logistic regression analysis were performed to confirm the association between shift work and chronic kidney disease stratified by gender.
Results The risk of CKD showed a significant increase (odds ratio = 2.04, 95% confidence interval = 1.22, 3.41) in the female worker group. The same results were obtained after all confounding variables were adjusted (odds ratio = 2.34, 95% confidence interval = 1.35, 4.07). However, the results of the male worker group were not significant.
Conclusions In this study using nationally representative surveys, we found that the risk of CKD was higher female workers and shift work. Future prospective cohort studies will be needed to clarify the causal relationship between shift work and CKD.
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Citations
Citations to this article as recorded by
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